顾燕敏 魏溢婷

[摘要] 目的 观察“反面素材”健康教育对提高患者及家属对压力性损伤预防的认知程度和依从性及减少压力性损伤发生的效果。 方法 选取2016 年10月至2018年10月我院骨科病区200例依从性差的卧床患者（Brend評分14分及以下），随机分为对照组100例和观察组100例。对照组进行常规的压力性损伤预防知识宣教（正面指导材料）。观察组在常规宣教基础上实施“反面素材”健康教育。比较两组患者压力性损伤知识掌握率、遵医行为、并发症的发生情况。 结果 观察组压力性损伤知识掌握率为95.00%（95/100），高于对照组的78.00%（78/100），观察组完全依从率为93.00%（93/100），高于对照组的75.00%（75/100），观察组未发生压力性损伤（0/100），明显低于对照组的6.00%（6/100），差异有统计学意义（P<0.05）。 结论 实施“反面素材”教育对骨科患者预防压力性损伤并发症有效。

[关键词] 反面素材教育模式;健康教育;依从性;压力性损伤

[中图分类号] R473.6          [文献标识码] B          [文章编号] 1673-9701（2021）30-0168-04

[Abstract] Objective To observe the effect of “negative material” health education on improving patients’ and their families’ awareness and compliance on the prevention of pressure injury and reducing the occurrence of pressure injury. Methods A total of 200 bedridden patients with poor compliance （Brend score of 14 points or less） admitted to the orthopedic ward of our hospital from October 2016 to October 2018 were selected and randomly divided into the control group （n=100） and the observation group （n=100）. The control group was given conventional education on prevention knowledge of pressure injury （positive guidance materials）， while the observation group was given “negative material” health education on the basis of conventional education. The mastery rate of pressure injury knowledge， compliance behavior and the incidence of complications were compared between the two groups of patients. Results The knowledge mastery rate of pressure injury in observation group was 95.00% （95/100）， higher than 78.00% （78/100） of control group.The complete compliance rate of observation group was 93.00% （93/100）， higher than 75.00% （75/100） of control group.There was no pressure injury in the observation group （0/100）， which was significantly lower than that in the control group [6.00%（6/100）]. the difference was statistically significant （P<0.05）. Conclusion The implementation of “negative materials” education is effective for orthopedic patients to prevent complications of pressure injury.

[Key words] Negative material education model; Health education; Compliance; Pressure injury

在各级医疗机构中压力性损伤均为临床护理中所面临的重点问题[1]，尤其是在骨科等病区，骨科由于大部分患者骨头完整性或连续性受损，常伴有疼痛、肿胀和身体相应功能的失用，卧床时间较长，且难以进行简单日常活动和翻身。基层医院骨科老年患者居多，患者普遍存在文化程度低、知识缺乏，依从性很差，由于害怕活动后疼痛、不适应角色改变、经济等原因，使身体局部骨突处长期受到较大压力且经常受到摩擦力、潮湿影响，导致压力性损伤发生，不仅给患者增加疼痛和经济负担，甚至会因严重感染而导致死亡[2]。……